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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

자료유형
학술저널
저자정보
Peter G. Passias (NYU Langone Orthopedic Hospital) Katherine E. Pierce (NYU Langone Orthopedic Hospital) Nicholas Kummer (NYU Langone Orthopedic Hospital) Oscar Krol (NYU Langone Orthopedic Hospital) Lara Passfall (NYU Langone Orthopedic Hospital) M. Burhan Janjua (Department of Neurosurgery Mercy Health) Daniel Sciubba (Department of Neurosurgery Johns Hopkins University School of Medicine) Waleed Ahmad (NYU Langone Orthopedic Hospital) Sara Naessig (NYU Langone Orthopedic Hospital) Bassel Diebo (Department of Orthopedics SUNY Downstate)
저널정보
대한척추신경외과학회 Neurospine Neurospine 제18권 제3호
발행연도
2021.9
수록면
628 - 634 (7page)
DOI
10.14245/ns.2040456.228

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초록· 키워드

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Objective: Malalignment of the cervical spine can result in cord compression, leading to a myelopathy diagnosis. Whether deformity or myelopathy severity is stronger predictors of surgical outcomes is understudied. Methods: Surgical cervical deformity (CD) patients with baseline (BL) and up to 1-year data were included. Modified Japanese Orthopaedic Association (mJOA) score categorized BL myelopathy (mJOA=18 excluded), with moderate myelopathy mJOA being 12 to 17 and severe myelopathy being less than 12. BL deformity severity was categorized using the mismatch between T1 slope and cervical lordosis (TS-CL), with CL being the angle between the lower endplates of C2 and C7. Moderate deformity was TS-CL less than or equal to 25° and severe deformity was greater than 25°. Categorizations were combined into 4 groups: group 1 (G1), severe myelopathy and severe deformity; group 2 (G2), severe myelopathy and moderate deformity; group 3 (G3), moderate myelopathy and moderate deformity; group 4 (G4), moderate myelopathy and severe deformity. Univariate analyses determined whether myelopathy or deformity had greater impact on outcomes. Results: One hundred twenty-eight CD patients were included (mean age, 56.5 years; 46% female; body mass index, 30.4 kg/m2) with a BL mJOA score of 12.8±2.7 and mean TS-CL of 25.9°±16.1°. G1 consisted of 11.1% of our CD population, with 21% in G2, 34.6% in G3, and 33.3% in G4. At BL, Neck Disability Index (NDI) was greatest in G2 (p=0.011). G4 had the lowest EuroQol-5D (EQ-5D) (p<0.001). Neurologic exam factors were greater in severe myelopathy (p<0.050). At 1-year, severe deformity met minimum clinically important differences (MCIDs) for NDI more than moderate deformity (p=0.002). G2 had significantly worse outcomes compared to G4 by 1-year NDI (p=0.004), EQ-5D (p=0.028), Numerical Rating Scale neck (p=0.046), and MCID for NDI (p=0.001). Conclusion: Addressing severe deformity had increased clinical weight in improving patient-reported outcomes compared to addressing severe myelopathy.
#Myelopathy #Correction #Cervical #Deformity #Outcomes

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참고문헌 (19)

참고문헌 신청
Moses MJ / 2019 / McGregor’s slope and slope of line of sight: two surrogate markers for ChinBrow vertical angle in the setting of cervical spine pathology / Spine J 19:1512~1517 google schola Chi JH / 2007 / Complex deformities of the cervical spine / Neurosurg Clin N Am 18:295~304 google schola Alexander B. Dru / 2019 / Cervical Spine Deformity Correction Techniques / Neurospine 16(3):470~482 dbpia Cho SK / 2019 / Cervical spine deformity: indications, considerations, and surgical outcomes / J Am Acad Orthop Surg 9(27):e555~e567 google schola Passias PG / 2018 / The relationship between improvements in myelopathy and sagittal realignment in cervical deformity surgery outcomes / Spine 43:1117~1124 google schola

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